Anthem Blue Cross and Blue Shield New Hampshire prior authorization 21172

Anthem Blue Cross and Blue Shield New Hampshire prior authorization for 21172: Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)

Code: 21172
Description: Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)
Source: New Hampshire Precertification List, Pg 87 Original policy

Anthem Blue Cross and Blue Shield New Hampshire prior authorization

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